All initial appointments are initial consultations and a “psychiatric evaluation”. This appointment is to understand the presenting problems or concerns you or your child is having and to obtain the history in regards to these problems. It is also to gather a medical history to both understand any association with physical health concerns as it relates to the presenting problem or gain an understanding of how one’s medical conditions could influence medical/psychiatric treatment (and vice versa).

At times, by the end of the initial visit, we’re confirming a previous diagnosis, exploring potentially newly uncovered diagnoses, or recognizing more information is required and further evaluating/testing, potentially with referrals to different specialists, are in order. Sometimes it's not easy to articulate the problems one is having, or to understand the problem thoroughly in one visit. It may then be determined that additional appointments are necessary to do so.

By the end of the consultation, however, it is collaboratively/mutually determined if the problem is understood well, and is recognized to be one your provider can help with you with. If so, a treatment plan is developed. Often, though depending on the nature of the problem and/or treatment, follow up appointments are made to review progress in this treatment plan.

Medications, as we often will acknowledge, can help with symptoms someone is having (e.g. depressed mood, poor energy, symptoms of panic or anxiety, insomnia, etc), but not what causes one’s symptoms, which typically only psychotherapy can provide. Having symptom relief, however, can enhance one’s quality of life, may allow engagement in one’s life that was previously inhibited, and permit improved global functioning. For some, medication alone may show some benefit but only have limited value and research continually points to combination of medication and psychotherapy as providing better outcomes than medication alone. When possible, priority and preference should always be given to psychosocial interventions first, like psychotherapy or behavioral therapy, before giving consideration to medication but, when those interventions are not enough, medications may be a suitable option.

Treatment with us is not done “to you” rather it’s a “with you” process. If medication is determined to be likely beneficial for you, or your child, and it is something that you are also interested in as a modality of treatment, your provider will work together with you to choose the best medication options for you. Working collaboratively, there will be a discussion of all potential risks and benefits of a proposed treatment plan and a discussion of potential alternatives to treatment. You will help your provider decide on the best treatment options for you. You will be closely followed up with to help determine if the current treatment plan is one worth continuing or if adjustments to the plan need to be made.

Psychotropic genetic testing evaluates one’s DNA to help determine response and/or tolerability a patient may have with a psychotropic medication. While there is mixed evidence in the utility of psychotropic genetic testing, in instances of repeated medication failures and/or issues with tolerability with numerous medications, such testing may be appropriate. Our providers use a company called Genesight for such testing.

Starting in March 2024, NPP Consultants is excited to announce we will be able to offer Spravato (Ketamine), an intranasal medication used in treating treatment-resistant depression and major depressive disorder with suicidal ideation/suicidal behavior. More information to come.